Which antihypertensive drug is the ONLY one known to cause drug-induced lupus erythematosus through a mechanism involving inhibition of complement and generation of reactive oxygen species from neutrophil myeloperoxidase?
- A Losartan
- B Amlodipine
- C Hydralazine ✓
- D Minoxidil
Correct answer: C. Hydralazine
Explanation
Hydralazine is the antihypertensive most classically associated with drug-induced lupus erythematosus (DILE). Its mechanism involves biotransformation by slow N-acetyltransferase-2 (NAT2) to reactive metabolites that modify histones and nuclear proteins, and neutrophil myeloperoxidase oxidises hydralazine to cytotoxic reactive species that trigger autoantibody formation (classically anti-histone antibodies, ANA positive, anti-dsDNA usually negative). Slow acetylators are at greatest risk. Losartan, amlodipine, and minoxidil do not cause drug-induced lupus.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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